MEDTECH 4: CAMBRIDGE BIOAUGMENTATION SYSTEMS

“At some point in every person’s life, you will need an assisted medical device-whether it’s your glasses, your contacts, or as you age and you have a hip replacement or a knee replacement or a pacemaker. The prosthetic generation is all around us.”

Aimee Mullins (Athlete)

Written by Safwaan Patel, Edited by Isaac Haq

OVERVIEW:

There are over 32 million amputees worldwide, with 185,000 amputations taking place in the US alone per year. Even with the advances in motor, sensory and manufacturing technologies in recent times, only 20% of these have a suitable prosthetic replacement. Cambridge Bioaugmentation Solutions propose an open standard for prosthetic connectivity to the body (think the USB port to plug a prosthetic into) to allow amputees to be truly bionic with wider availability, ease of use and reduced costs of up to 60%.

PROBLEM + SOLUTION:

The limited use of prosthesis in amputees can be attributed largely to the high costs. Advanced systems such as Blatchford’s Linx cost upwards of £20,000, proving prohibitive for availability on the NHS and even more so in third world countries where the burden of amputation is higher.

Additionally, the current “socket” prosthesis being fitted over a surgically crafted stump can be uncomfortable as load-bearing is through the flesh of the stump rather than the bone. The result is a 48% rate of skin infection and painful sores per year. Sockets are also fitted individually to ensure an appropriate fit and regularly adjusted resulting in average overall care costs of £9000 per patient per year. The solution from CBAS is surgically fitting a permanent ‘adaptor’ to the bone of the amputated limb that becomes osseointegrated (bone attaches to the titanium), transferring the load onto the bone and avoiding the need for refitting.

THE SCIENCE:

A 2011 study comparing osseointegration and sockets showed usage of the prosthesis and subjective quality of life doubled whilst walking speed increased by 32%. The savings in follow-up costs for prosthesis make this an attractive prospect from healthcare providers point of view, with the ease of use and flexibility to be able to interchange attachments without the need for professional health being of direct benefit to the patients.

The gold-standard for a prosthesis is for it to be controlled as a normal hand would be, providing sensory and proprioceptive (sense of position) feedback. Current myoelectric control uses existing muscle electrical signals to move the prosthesis but entails a steep learning curve and the result is often coarse movement. CBAS are researching machine learning and neural integration to allow smoother and more natural control of any plugged in prosthetics, with the goal being a true replacement or maybe even an improvement over the original limb.

MARKET AND COMPETITORS:

The global market in orthopedic prosthetics is estimated at $1.62bn andforecasted to grow by 5% a year until 2026 due to increasing amputations as a burden of increasing diabetes and obesity worldwide. $790.8M of this market is for robotic rather than simple prosthetics, showing there is a large demand for more advanced ‘bionic’ functional capability. Osseointegration is already integrated into a few newer prostheses such as Integras OPRA implant system, but these competitors are thus far limited by their lack of compatibility with other systems.

BUSINESS/FINANCING:

CBAS aim to develop their technology as an open standard in order to create a ‘plug and play’ system for prosthetics, monetizing by licensing their technology to prosthetic manufacturers. Thus far they have partnered with Cisco, GSK and Open Bionics but have a long road ahead in rolling out universally. Funding has been limited to a recent £100,000 Innovate UK grant and a £50,000 Mass challenge diamond award but further investment will be needed to scale the business up as they move from pre-clinical trials to commercialisation.

DRIVERS OF GROWTH:

Simple: End-user friendly system.

Growing market: Both in developed and with increased demand from emerging markets.

Evolving healthcare market: Reduced costs both for up-front fitting and follow up for readjustment and complications appeal to healthcare providers who largely control provision of prosthetics to patients.

3D printing culture: Imagine being able to print out your own prosthetic for any occasion; after all you wouldn’t want to wear your sports hand to a black tie event! A universal adaptor to plug into would be the first step towards this being a reality.

Flexibility: By providing a solution for a universal adaptor, they target the whole prosthetic market rather than being simply another player in the crowd.

INHIBITORS OF GROWTH:

Feasibility: With existing prosthetic manufacturers each having their own adaptor system, its a difficult task to gather each and get an agreed single standard.

Surgical requirements: Need for specific surgery and rehabilitation

Regulation: Market regulations are strict for prosthetic devices putting a number of hurdles in the way before the product reaches the market.

Disclaimer:1) This blog has been created using public information about Cambridge BioAugmentation Systems2) This is an opinion piece intended only for educational purposes, not as professional investment advice.3) I can declare no conflicts of interest in the publication of this article.